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how hard should i push for 17p (progesterone) shots?

post #1 of 12
9/11/12 at 9:18am
Thread Starter 

DD was born at 35 weeks due to PPROM. My water broke and by the time we got to the hospital about an hour later I was in full-blown labor. Contractions every 5 minutes. DD had a NICU stay and now had some chronic health issues. I had only 1 ultrasound at 20 weeks, there is no evidence that my cervix was shortening at the time of PPROM. (It could have been, there's just no evidence.)

 

I asked the MW about 17p shots and she talked to the doctor that oversees the MW's practice. Doc said no - not sure why. Is it reasonable to ask for a meeting with the doc? A longer meeting with the MW about the shots? Since there's no real side-effects to the shots and I meet the requirements (1. Previous PPROM and 2. Singleton pregnancy) I can't really understand why they would say no.

 

I feel VERY strongly that I want these shots. I don't want to risk out of the MW practice - I'm trying for a VBAC and I'm overweight. But, aside from the PPROM, my previous pregnancy was completely uncomplicated.

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post #2 of 12
9/11/12 at 9:42am
Hi.

I just had a successful pregnancy after a previous early delivery and I did have the 17p shots. I felt that they were probably helpful at helping this pregnancy go as long as it did. I went past 36 weeks and my son was healthy. No NICU stay this time. The pregnancy was pretty difficult with cervical shortening preterm labor and a ton of bleeding throughout. I was thrilled to get to 36 weeks before my water broke.

I would talk to your midwife and the doctor too if necessary. You need to know what the doctor's recommendation is based on. A flat no with no explanation would not be enough for me. This doctor may not be well informed of the benefits of this treatment and some of the recent studies that have been done. My doctor said that she was previously dubious of the 17p but in her own practiceshe has had very positive outcomes with those who used this treatment. She is now really encouraging women who fit the ctiteria to consider the injections.

Ultimately this is your decision. I know you want to stay with your midwife so talk to her and tell her what you want. If she won't work with you then you can decide what you want to do next. I wish you all the best for a healthy pregnancy
post #3 of 12
9/11/12 at 10:18am
It is completely reasonable to insist on discussing this with the doctor! I don't know what his reasoning is, but i'd want to get answers to that question straight from the source, face to face, not filtered through any third party.
post #4 of 12
9/14/12 at 7:09am

Totally talk with the doctor.  The official ACOG guideline is "progesterone supplementation for the prevention of recurrent preterm birth should be offered to women with a singleton pregnancy and a prior spontaneous preterm birth due to spontaneous preterm labor or premature rupture of membranes."  If you're not receiving that standard of care it's worth pushing to know why.  My midwife practice gave me the shots from 17 weeks until 36 weeks-- receiving them didn't risk me out of the practice-- and I delivered at 40w 3d.  (My first was 34w5d after PPROM, and a week in the NICU.)

 

I was one of the "high risk" patients in the midwife practice, and that meant the midwives discussed my case with the OB regularly.  I'm guessing it would be something similar where you are, so now may be a good time to make sure you like the OB and think s/he is competent to make good decisions about your pregnancy in the future too.  Personally, when I got to around 34 weeks and started getting nervous, I found it VERY reassuring to have an appointment with the OB herself to talk about fFN tests/cervix checks/etc. 

 

Best of luck to you, and here's hoping for a healthy full term babe this time!

post #5 of 12
9/14/12 at 11:00am
Thread Starter 

i made the appointment with the doc. bringing this along: http://www.acog.org/Resources_And_Publications/Committee_Opinions/Committee_on_Obstetric_Practice/Use_of_Progesterone_to_Reduce_Preterm_Birth

 

:)

post #6 of 12
9/17/12 at 6:02am

Go get 'em!  Let us know how it turns out?

post #7 of 12
10/23/12 at 3:38pm

Came on to post nearly the same initial question, so thought I'd bump this one & see if Whoabethy or anyone else has any additional comments/info...

 

DD was born 35wks for no particular reason that they could ever find. I'm 15 wks with #2 presently, and my Midwife is asking me to consider the Progesterone shots in the near future. She has scheduled me a chat with the overseeing OB to discuss. I'd like to come armed with some info, as I don't know much about the shots, and am generally not big on meds, ESP when preg.

 

Thoughts?? Reasonably safe? Side effects? Risks? 

**In labor with DD they gave me multiple Terbutaline shots, to no avail - and I only recently stumbled upon info that suggests a possible correlation with Autism. My aversion to medication has only multiplied in recent weeks because of this discovery. All to say, I'm not initially wild on the Progesterone idea, and would need some serious convincing from NATURALly-minded Mamas/drs/midwives that there won't be side effects discovered down the line after the fact. 

post #8 of 12
10/24/12 at 5:37am

FWIW my earthy-crunchy midwife recommended them, and said they're just the same progesterone your body should make be making naturally. Definitely talk to your doctor, but for me taking shots of a hormone during my pregnancy was totally worth it to avoid all kinds of medical interventions with a preemie later on.  Best wishes for a nice long healthy pregnancy in any case!

post #9 of 12
10/24/12 at 10:16am
I agree with pigirl. I am very anti-medicine but I felt that getting the 17-p would help me avoid things like terbutaline and mag. and NICU stay for the baby. I did have to be hospitalized this last time and delivered at 36 weeks but I really feel that the 17-p helped me get get that far and things would have been much worse without it. would do it again in a heartbeat. There weren't any significant side effects. It was just a little uncomfo.rtable at the injection site. Good luck with your decision and I wish for you a healthy long pregnancy.
post #10 of 12
10/24/12 at 10:39am

Based on my experience I would continue to push.  Let us know how it works out. 

post #11 of 12
10/26/12 at 11:40am
Thread Starter 

well, i FINALLY met with the supervising doc and she approved the shots! i start on monday (only 6 weeks late)! thanks for the encouragement, ladies!

post #12 of 12
10/29/12 at 6:49am

What a pain!  I'm glad you were finally able to talk to the doc.  May you have a long, boring third trimester and a healthy full term baby!

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Mothering › Mothering Discussion Forums › Parenting › Ages and Stages › NICU & Preemie Parenting › how hard should i push for 17p (progesterone) shots?